The Virtual Clinic: Two-sided Affordances in Consultation Practice

Abstract

Telecare has the potential to increase the quality of care while also decreasing costs. However, despite great potential, efficiency in care practices and cost reduction remain hypothetical. Within computer supported cooperative work (CSCW), one focus of telecare research has been on awareness support in distributed real-time communication in comparison to physical meetings since face-to-face consultations have been known as the "gold standard" of conducting care. Research has shown that it is hard to maintain qualities such as awareness through video-mediated meetings. In this research, the goal has not been to mimic the qualities of face-to-face consultations but rather to document the qualities of three types of patient meetings (consultations) and to understand in what kinds of situations each consultation type is a viable option. In this paper, we focus on the essential qualities of i) face-to-face consultations, ii) video-based consultations, and iii) telephone consultations and shed light on their affordances. The research contribution includes an extension of the affordance lens to incorporate socio-technical, two-sided affordances, that constitute important aspects for understanding complexity when heterogeneous actors co-existing in a practice, where affordances can differ for different "sides" in the complex practice-a view that is fruitful when dealing with heterogeneous actors and a set of analog and digital tools in a practice.